參與進階制度護理人員的自覺護理能力及其相關因素調查

本研究目的在探討不同進階層級護理人員在自覺護理能力、護理行政支持、護理工作環境覺知、工作滿意、留任意願之現況，並探討自覺護理能力之預測因子。採橫斷式的調查研究法，在高屏地區一家醫學中心及二家區域醫院，以立意取樣方式，排除新進護理人員及護理長（含）以上之護理主管，選擇所有參與『專業能力進階制度』之全體護理人員為收案對象，共計發出1760份問卷，回收1628份問卷，回收率為92.5％，扣除未填寫完整問卷20份，共計有效問卷1608份。採結構式量表，包括個人及工作基本屬性問卷、護理行政支持量表、自覺護理能力量表、護理工作環境覺知量表、工作滿意量表及留任意願量表等進行資料收集，並以SPSS10.0中文版電腦套裝軟體進行資料分析。研究結果發現：（1）所有受試者之自覺護理能力總平均值為156.18（±22.29）、護理行政支持之總平均值為30.51（±5.13）、護理工作環境覺知之總平均值為130.68（±18.56）、工作滿意之總平均值為22.08（±3.74）、留任意願之總平均值為6.92（±2.18）；不同進階層級護理人員在自覺護理能力（F（2,1605）＝82.42, p＜.01）、護理行政支持（F（2,1605）＝25.78, p＜.01）與護理工作環境覺知（F（2,1605）＝8.72, p＜.01）有顯著差異，經Scheffe事後比較結果，顯示進階層級愈高者，其自覺護理能力、護理行政支持及護理工作環境覺知也愈高，但不同進階層級護理人員在工作滿意（F（2,1605）＝2.41, p＝.09）及留任意願（F（2,1605）＝0.45, p＝.64）無顯著差異；（2）自覺護理能力與護理行政支持（r＝.13, p＜.01）、護理工作環境覺知（r＝.40, p＜.01）、工作滿意（r＝.27, p＜.01）、留任意願（r＝.25, p＜.01）等變項有顯著正相關，表示護理行政支持、護理工作環境覺知、工作滿意及留任意願愈高者，其自覺護理能力愈好；（3）自覺護理能力之預測因子為護理工作環境覺知、護理工作總年資、目前進階層級、教育程度、護理行政支持和工作滿意等六項（F＝127.55, p＜.01），可解釋自覺護理能力的總變異量達32.1％。本研究結果建議提升護理工作環境、積極推動『專業能力進階制度』、重視護理人員的工作滿意、留任意願與護理能力之關係，透過適切的護理人員招募與留任措施，以提升護理人員留任意願，並維持護理業務之穩定發展，進而提升整體的護理能力，本研究結果可作為護理行政管理與政策擬定之參考。

關鍵字

自覺護理能力；護理行政支持；護理工作環境覺知；工作滿意；留任意願；專業能力進階層級

並列摘要

Objectives: The purposes of this study are to explore the relationships among nursing administration support, job satisfaction, job retention and perceived nursing competence of the nurses at different levels of nursing clinical ladder, and to investigate the predictors of perceived nursing competency. Materials and Methods: The study is a cross-sectional survey. A purposeful sample was recruited from one medical center and two regional hospitals in Southern Taiwan. The subjects include all nurses participating in the clinical ladder in tested hospitals. New nurses with N0 and nursing administrator where excluded. A set of structured questionnaires which include demographics and working characteristics, perceived nursing competence, perception of nursing working environment, job satisfaction, and job retention, was used for data collection. A total of 1760 questionnaires were sent out, and 1608 effective questionnaires were used for analysis. All data were analyzed with computer software SPSS 10.0. Results: The means and standard deviation of perceived nursing competence, nursing administration support, perception of nursing working environment, job satisfaction, and job retention were 156.18 ± 22.29, 30.51±5.13, 130.68±18.56, 22.08±3.74, and 6.92±2.18, respectively. Perceived nursing competence, nursing administration support, and perception of nursing working environment showed significant differences among the nurses at different levels of clinical ladder. Post-hoc analysis indicated nurses at the higher level of nursing clinical ladder, the higher degree of perceived nursing competence, nursing administration support, and perception of nursing working environment. Nursing administration support, perception of nursing working environment, job satisfaction, and job retention were positively correlated with perceived nursing competence. Perception of nursing working environment, working years, level of clinical ladder, education, nursing administration support, and job satisfaction were predictors of perceived nursing competence, and they accounted 32.1% of its variance. Conclusion: The results of this study reveal that there are positive correlations between perceived nursing competence and perception of nursing working environment, nursing administration support, job satisfaction, and job retention. By improving nursing working environment, clinical ladder, job satisfaction and job retention, it will encourage nurses to pursuit nursing competence. The results might provide references administrators to improve clinical ladder and making policy.

並列關鍵字

Perceived nursing competence ； Nursing administration support ； Perception of nursing working environment ； Job satisfaction ； Job retention ； Clinical ladder.